Uptake of lung cancer screening with low-dose computed tomography in China: A multi-centre population-based study
Summary: Background: Optimal uptake rates of low-dose computed tomography (LDCT) scans are essential for lung cancer screening (LCS) to confer mortality benefits. We aimed to outline the process model of the LCS programme in China, identify the high-risk individuals with low uptake based on a prosp...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | EClinicalMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022003248 |
| _version_ | 1811222392078336000 |
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| author | Wei Cao Fengwei Tan Kuangyu Liu Zheng Wu Fei Wang Yiwen Yu Yan Wen Chao Qin Yongjie Xu Liang Zhao Wei Tang Jiang Li Xuesi Dong Yadi Zheng Zhuoyu Yang Kai Su Fang Li Jufang Shi Jiansong Ren Yunyong Liu Lianzheng Yu Donghua Wei Dong Dong Ji Cao Shaokai Zhang Shipeng Yan Ning Wang Lingbin Du Wanqing Chen Ni Li Jie He |
| author_facet | Wei Cao Fengwei Tan Kuangyu Liu Zheng Wu Fei Wang Yiwen Yu Yan Wen Chao Qin Yongjie Xu Liang Zhao Wei Tang Jiang Li Xuesi Dong Yadi Zheng Zhuoyu Yang Kai Su Fang Li Jufang Shi Jiansong Ren Yunyong Liu Lianzheng Yu Donghua Wei Dong Dong Ji Cao Shaokai Zhang Shipeng Yan Ning Wang Lingbin Du Wanqing Chen Ni Li Jie He |
| author_sort | Wei Cao |
| collection | DOAJ |
| description | Summary: Background: Optimal uptake rates of low-dose computed tomography (LDCT) scans are essential for lung cancer screening (LCS) to confer mortality benefits. We aimed to outline the process model of the LCS programme in China, identify the high-risk individuals with low uptake based on a prospective multi-centre population-based cohort, and further explore associated structural characteristics. Methods: A total of 221,955 individuals at high-risk for lung cancer from the National Lung Cancer Screening cohort were included. The logistic regression model was performed to identify the individual characteristics associated with the uptake of LCS, defined as whether the high-risk individual undertook LDCT scans in designated hospitals within six months following the initial risk assessment. The linear regression model was adopted to explore the structural characteristics associated with the uptake rates in 186 communities. Findings: The overall uptake rate was 33·0%. The uptake rate was negatively correlated with the incidence of advanced-stage lung cancer (Pearson's coefficient −0·88, p-value 0·0007). Multivariable regression models found that lower uptake rates were associated with males (OR 0·88, 95%CI 0·85–0·91), current smokers (OR 0·93, 95%CI 0·90–0·96), individuals with depressive symptoms (OR 0·92, 95%CI 0·90–0·94), and the structural characteristics, including longer structural delays in initiating LDCT scans (30–90 days vs. ≤14 days: β −7·17, 95%CI −12·76∼ −1·57; >90 days vs. ≤14 days: β −13·69, 95%CI −24·61∼ −2·76), no media-assisted publicity (β −6·43, 95%CI −11·26∼ −1·60), and no navigation assistance (β −5·48, 95%CI −10·52∼ −0·44). Interpretation: Multifaceted interventions are recommended, which focus on poor-uptake individuals and integrate the ‘assessment-to-timely-screening’ approach to minimise structural delays, media publicity, and a navigation assistance along the centralised screening pathway. Funding: Ministry of Finance and National Health Commission of the People's Republic of China. |
| first_indexed | 2024-04-12T08:15:02Z |
| format | Article |
| id | doaj.art-e964bb5308ce41a5bcf41409da86bec0 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-12T08:15:02Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-e964bb5308ce41a5bcf41409da86bec02022-12-22T03:40:49ZengElsevierEClinicalMedicine2589-53702022-10-0152101594Uptake of lung cancer screening with low-dose computed tomography in China: A multi-centre population-based studyWei Cao0Fengwei Tan1Kuangyu Liu2Zheng Wu3Fei Wang4Yiwen Yu5Yan Wen6Chao Qin7Yongjie Xu8Liang Zhao9Wei Tang10Jiang Li11Xuesi Dong12Yadi Zheng13Zhuoyu Yang14Kai Su15Fang Li16Jufang Shi17Jiansong Ren18Yunyong Liu19Lianzheng Yu20Donghua Wei21Dong Dong22Ji Cao23Shaokai Zhang24Shipeng Yan25Ning Wang26Lingbin Du27Wanqing Chen28Ni Li29Jie He30Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaDepartment of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, United StatesOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaDepartment of Diagnostic Radiology, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaDepartment of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaDepartment of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, ChinaLiaoning Center for Disease Control and Prevention, Shenyang 110005, ChinaOffice for Cancer Prevention and Control, Anhui Provincial Cancer Hospital, Hefei 230031, ChinaOffice of Cancer Prevention and Treatment, Xuzhou Cancer Hospital, Xuzhou 221000, ChinaCancer Prevention and Control Office, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, ChinaDepartment of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou 450008, ChinaDepartment of Cancer Prevention and Control, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410000, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaDepartment of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)/Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou 310022, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, ChinaOffice of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Corresponding author at: Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement; No.17 Panjiayuannanli, Chaoyang District, Beijing 100021, China.Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; Corresponding author at: Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 Panjiayuannanli, Chaoyang District, Beijing 100021, China.Summary: Background: Optimal uptake rates of low-dose computed tomography (LDCT) scans are essential for lung cancer screening (LCS) to confer mortality benefits. We aimed to outline the process model of the LCS programme in China, identify the high-risk individuals with low uptake based on a prospective multi-centre population-based cohort, and further explore associated structural characteristics. Methods: A total of 221,955 individuals at high-risk for lung cancer from the National Lung Cancer Screening cohort were included. The logistic regression model was performed to identify the individual characteristics associated with the uptake of LCS, defined as whether the high-risk individual undertook LDCT scans in designated hospitals within six months following the initial risk assessment. The linear regression model was adopted to explore the structural characteristics associated with the uptake rates in 186 communities. Findings: The overall uptake rate was 33·0%. The uptake rate was negatively correlated with the incidence of advanced-stage lung cancer (Pearson's coefficient −0·88, p-value 0·0007). Multivariable regression models found that lower uptake rates were associated with males (OR 0·88, 95%CI 0·85–0·91), current smokers (OR 0·93, 95%CI 0·90–0·96), individuals with depressive symptoms (OR 0·92, 95%CI 0·90–0·94), and the structural characteristics, including longer structural delays in initiating LDCT scans (30–90 days vs. ≤14 days: β −7·17, 95%CI −12·76∼ −1·57; >90 days vs. ≤14 days: β −13·69, 95%CI −24·61∼ −2·76), no media-assisted publicity (β −6·43, 95%CI −11·26∼ −1·60), and no navigation assistance (β −5·48, 95%CI −10·52∼ −0·44). Interpretation: Multifaceted interventions are recommended, which focus on poor-uptake individuals and integrate the ‘assessment-to-timely-screening’ approach to minimise structural delays, media publicity, and a navigation assistance along the centralised screening pathway. Funding: Ministry of Finance and National Health Commission of the People's Republic of China.http://www.sciencedirect.com/science/article/pii/S2589537022003248Lung cancerScreeningUptakePopulation-based studyChina |
| spellingShingle | Wei Cao Fengwei Tan Kuangyu Liu Zheng Wu Fei Wang Yiwen Yu Yan Wen Chao Qin Yongjie Xu Liang Zhao Wei Tang Jiang Li Xuesi Dong Yadi Zheng Zhuoyu Yang Kai Su Fang Li Jufang Shi Jiansong Ren Yunyong Liu Lianzheng Yu Donghua Wei Dong Dong Ji Cao Shaokai Zhang Shipeng Yan Ning Wang Lingbin Du Wanqing Chen Ni Li Jie He Uptake of lung cancer screening with low-dose computed tomography in China: A multi-centre population-based study EClinicalMedicine Lung cancer Screening Uptake Population-based study China |
| title | Uptake of lung cancer screening with low-dose computed tomography in China: A multi-centre population-based study |
| title_full | Uptake of lung cancer screening with low-dose computed tomography in China: A multi-centre population-based study |
| title_fullStr | Uptake of lung cancer screening with low-dose computed tomography in China: A multi-centre population-based study |
| title_full_unstemmed | Uptake of lung cancer screening with low-dose computed tomography in China: A multi-centre population-based study |
| title_short | Uptake of lung cancer screening with low-dose computed tomography in China: A multi-centre population-based study |
| title_sort | uptake of lung cancer screening with low dose computed tomography in china a multi centre population based study |
| topic | Lung cancer Screening Uptake Population-based study China |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022003248 |
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